In Several States, Medicaid Expansion Remains in Limbo as Time Runs Short

May 6, 2013

In the closing days of their legislative sessions, lawmakers in more than a dozen states are struggling with whether to expand Medicaid under the federal health care law, with many of them leaning against participating in a program that is key to President Obama's aim of extending coverage to 30 million uninsured Americans, says the Washington Post.

Twenty states and the District of Columbia have signed on to the expansion, and 14 are planning to decline.

But 16 remain in limbo as lawmakers clash in the final days and weeks of the legislative calendar, when many must come to a decision in time for the provision to kick in next year.

The three-year-old health care law faces perhaps its greatest challenge this fall: enrolling millions of Americans in health insurance beginning Oct. 1. Much has been left up to the states, which have taken up the law with varying levels of enthusiasm.

More than half have decided not to set up the online marketplaces meant to help people find insurance and financial assistance, leaving the enormous task to the federal government.

Many states are also wary of the expense of adopting the law's enlargement of the pool of people eligible for Medicaid.

While some states that are leaning against expansion are holding special sessions to consider their options, others are looking at a compromise measure that would allow them to use the federal dollars to buy people private insurance, an idea pioneered by Arkansas.

The issue remains open virtually everywhere, partly because there is no firm deadline to opt in or out, but also because of the huge sums of money at stake. The Obama administration has devoted half a trillion dollars over 10 years to pay for the expansion.